• Fetal monitoring in pregnant women with complicated obstetric history
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Fetal monitoring in pregnant women with complicated obstetric history

HEALTH OF WOMAN. 2017.6(122):111–114; doi 10.15574/HW.2017.122.111

Vorobey L. I.
National Medical Academy of Postgraduate Education PL Shupika, Kyiv
Kyiv City Center for Reproductive and Perinatal Medicine

The objective: to establish the features of fetus functional state definition in pregnant women with perinatal losses in history.

Patients and methods. 89 pregnant women with perinatal losses in history were screened. The fetus functional status evaluation was based on cardiotocography and definition of fetal heart rate variability by cardiointervalography.

Results. Received data showed the decrease of SDNN, RMSSD and pNN50 in pregnant women with perinatal losses in history, indicating the prevalence of parasympathetic effects on the fetal myocardium (p<0.05). Studies of mathematical time characteristics of fetal heart rate revealed a significant overweight of the metabolic-humoral regulatory circuit in women with normal pregnancy (p<0.05). Dynamic stress index evaluation indicates the centralization of heart rate regulation and significant intensity of the fetal compensatory mechanisms in pregnant women with perinatal losses in history. The cardiotocography revealed no difference between the fetal status in women of comparative groups (p>0.05).

Conclusions. In pregnant women with perinatal losses in history owing to autonomic nervous system disregulation a significant intensity of fetal regulatory systems and the centralization of fetal cardiac rhythm control were observed. The cardiotocography and cardiointervalography data with revealed signs of excessive sympathetic activation can serve as preclinical signs of gestational pathology.

Key words: perinatal losses, fetal functional state evaluation, cardiotocography, cardiointervalography, autonomic nervous system.

REFERENCES

1. Abzalova NA, Igitova MB, Trubnikov PN. 2007. Otsenka adaptatsionnyih vozmozhnostey donoshennogo ploda na osnove kardiointervalografii. Sibirskiy meditsinskiy zhurnal. Tomsk. 22;2.

2. Abuladze GV, Papitashvili AM. 2003. Spektralnyie svoystva variabelnosti chastotyi serdechnogo ritma ploda. Norma i klinicheskoe primenenie. Ultrazvukovaya i funktsionalnaya diagnostika. 2:128–137.

3. Bokeriya LA, Bokeriya OL, Volkovskaya IV. 2009. Variabelnost serdechnogo ritma: metodyi izmereniya, interpretatsiya, klinicheskoe ispolzovanie. Annalyi aritmologii 6;4.

4. Vetchanina EG, Malgina GB. 2001. Osobennosti reaktsiy beremennyih na psihoemotsionalnyiy stress v razlichnyie sroki beremennosti. Sibirskiy psihologicheskiy zhurnal 14–15.

5. Gudkov GV. 2010. Antenatalnaya kardiotokografiya v snizhenii perinatalnyih poter. Avtoref. diss. d-ra med. nauk. M.

6. Espaeva RN i dr. 2014. Faktoryi riska antenatalnoy gibeli ploda. Vestnik Kazahskogo Natsionalnogo meditsinskogo universiteta 2–4.

7. Zharkin NA, Tsyibulskaya OV, Burova NA. 2012. Sovremennyie aspektyi profilaktiki ranney poteri beremennosti. Lekarstvennyiy vestnik 6;8:3–6.

8. Kan NI, Nikolaeva-Ball DR. 2017. Patofiziologicheskie osobennosti adaptatsii v sisteme «mat–plod» pri metabolicheskom sindrome i preeklampsii. Ulyanovskiy mediko-biologicheskiy zhurnal 1.

9. Kipchatova TYu i dr. 2012. Sootnosheniya riska progressirovaniya fetoplatsentarnoy nedostatochnosti s razlichnyimi narusheniyami vegetativnogo statusa beremennyih. Saratovskiy nauchno-meditsinskiy zhurnal 8;2.

10. Kiselev AR, Gridnev VI. 2011. Kolebatelnyie protsessyi v vegetativnoy regulyatsii serdechno-sosudistoy sistemyi (obzor). Saratovskiy nauchno-meditsinskiy zhurnal 7;1.

11. Lahno IV. 2012. Neinvazivnaya antenatalnaya kompyuternaya elektrokardiografiya ploda versus kardiotokografiya: pervyiy opyit v Ukraine. Meditsina neotlozhnyih sostoyaniy 1 (40).

12. Pavlova NG. 2015. Antenatalnaya kardiotokografiya – problemy i vozmozhnosti. Zhurnal akusherstva i zhenskih bolezney 64;2.

13. Strizhakov AN i dr. 2015. Patofiziologiya ploda i platsentyi. M, GEOTAR-Media.

14. Tkachenko EV. 2004. Znachenie vegetativnyih regulyatornyih protsessov v mehanizmah lateralizatsii sosudistogo tonusa pri beremennosti. Avtoref. diss. kand. med. nauk. Stavropol.

15. Tolmachev IV. 2012. Funktsionalnyie vzaimootnosheniya sistemyi «mat–plod» v tretem trimestre beremennosti i rannem neonatalnom periode. Avtoref. diss. kand. med. nauk. Tomsk.

16. Ushakova GA. 2014. Biofizicheskie mehanizmyi gravidarnogo gomeostaza. Mat i ditya v Kuzbasse 4.

17. Ushakova GA i dr. 2016. Sovremennyie podhodyi k otsenke serdechnogo ritma ploda (obzor literaturyi). Mat i ditya v Kuzbasse 1.

18. Ushakova GA, Petrich LN. 2008. Neyrovegetativnaya regulyatsiya kardioritma materi i ploda pri hronicheskoy platsentarnoy nedostatochnosti. Mat i ditya v Kuzbasse 3:21–25.

19. Chehonatskaya ML i dr. 2012. Osobennosti psihoemotsionalnogo statusa u beremennyih s fetoplatsentarnoy nedostatochnostyu. Saratovskiy nauchno-meditsinskiy zhurnal 8;2.

20. Shilova NV. 2007. Sostoyanie vegetativnoy nervnoy sistemyi u beremennyih s neyrotsirkulyatornoy distoniey pri fizicheskoy reabilitatsii. Fizicheskoe vospitanie studentov tvorcheskih spetsIalnostey: 109.

21. Yabluchanskiy NI, Martyinenko AV. 2010. Variabelnost serdechnogo ritma v pomosch prakticheskomu vrachu.

22. Robinson B, Nelson L. 2008. A Review of the Proceedings from the 2008 NICHD Work shopon Standardized Nomenclature for Cardiotocography: Updateon Definitions, Interpretative Systems With Management Strategies, and Research Priorities in Relation to Intrapartum Electronic Fetal Monitoring. Rev. Obstet. Gynecol. 1;4:186–192. PMid:19173023 PMCid:PMC2621055